Patient Financial Counselor

Conway Medical Center•Conway, SC

About The Position

The Patient Financial Counselor determines client eligibility for enrollment in available community programs, including local funding and Medicaid. The role delivers high-quality customer service to a diverse client base, including clients with special needs, and applies technical knowledge to analyze application materials, make appropriate eligibility decisions, and ensure policies and procedures are applied appropriately. The counselor assists patients with financial assistance and Health Exchange applications, collects inpatient and observation out-of-pocket expenses, reviews financial assistance requests and related correspondence, and works with outside agencies to identify patient qualifications for Conway Medical Center or South Carolina programs. The role also reviews admissions for adequate payer sources and establishes plans to secure payment resources and maximize hospital reimbursement.

Requirements

High school diploma or equivalent.
At least 3 years of general patient accounting experience.
At least 2 years of customer service experience.
Knowledge of Medicare, Medicaid, HMO, PPO, and commercial insurance guidelines.
Working knowledge of Word, Excel, and other Microsoft applications.
Effective communication skills and the ability to maintain excellent working relationships with patients and physicians.
Certification with SCDHHS (Health Exchange Program) within 12 months of hire.

Nice To Haves

AAHAM or CRCS certification preferred.

Responsibilities

Apply knowledge of Conway Medical Center collection policies and procedures and Financial Assistance roles.
Collect inpatient and observation out-of-pocket expenses while patients are in-house, including deductibles, co-payments, services excluded by insurance, and negotiated self-pay amounts.
Review Charity Pending requests, requests for itemized bills or claims, and incoming mail accurately and promptly.
Follow up on Financial Assistance requests through email, the Patient Portal, and telephone.
Assist patients with the application process, including the Health Exchange Program.
Schedule appointments to collect financial statements, unemployment information, Social Security information, and other funding documentation.
Greet patients and accompanying family members and provide exemplary customer service.
Coordinate with outside agencies regarding patient qualifications for Conway Medical Center or State of South Carolina programs.
Serve patients who exceed the Health Care District Coordinated Care Federal Poverty Level Guidelines but meet Charity Care guidelines.
Interview people in need of services and help them navigate the documentation process.
Review inpatient and observation admissions for an adequate payer source and establish plans to secure payment resources and maximize hospital reimbursement.
Work collaboratively with colleagues, physicians, and department heads.
Use strong organizational skills and effective verbal communication.
Use technology and PC skills proficiently and exercise independent judgment.
Complete other duties assigned by department leadership.